Education and Logistics
- Because physiologic responses and adaptations differ importantly between moderately high altitudes (8,000–12,000 ft [2,438–3,658 m]) and extremely high altitudes (greater than 18,000 ft [5,486 m]), planning for military training or military missions at high altitudes should take these differences into account.
- Individuals who have not yet regained lean body mass lost in prior field operations should not be deployed to cold or high-altitude environments until lean body mass is regained.
Military troops, leaders, and medical personnel being assigned to high-altitude training or missions should be fully instructed on the symptoms and signs of AMS, subacute mountain sickness, high-altitude pulmonary edema (HAPE), and high-altitude cerebral edema (HACE). In addition, they should be trained in the use of appropriate countermeasures and therapy.
Because about 25 percent of people seem to be ''immune" to AMS, military personnel who have successfully completed a tour at altitude should be the ones selected for assignment to altitude missions of unique military importance. Conversely, those who have developed AMS during training at high altitudes should be excluded in advance from participating in such unique military missions whenever possible.
- Information about possible changes in physical performance, alertness, and emotional stability associated with hypoxia should be provided to all levels of command so that soldiers and their leaders will not be surprised when they occur. Breakdown in troop cohesion should be anticipated.
- Because weight loss is common during military operations at high altitudes, command and logistical practices should attempt to ensure, whenever possible, that the availability of palatable foods and fluids, as well as the social setting at mealtimes, are optimized to insure adequate dietary intakes (see IOM, 1995).
- Logistical measures for cold-weather operations must put primary emphasis on the delivery and maintenance of sufficient food stores and unfrozen dietary fluids.
- Military rations are the fuel for the soldier and emphasis should be placed on adequate availability and consumption of operational rations to maintain performance in these harsh environments.
AREAS FOR FUTURE RESEARCH
The Committee on Military Nutrition Research suggests a number of areas for future research within the military related to nutrition for soldiers working